Metatarsalgia – Causes & Cures

What is Metatarsalgia?

Metatarsalgia is the name we use to describe pain to the front part of your foot – or forefoot. ‘Metatars’ – affecting your metatarsal bones and ‘algia’ is from Greek, to describe pain. Metatarsalgia is not an illness in itself, but more a description of pain that has an underlying cause or causes, which we’ll look at below. In some cases, the metatarsal bone(s) can even end up with a stress fracture.

Where Does It Occur?

Metatarsalgia affects the front of your foot – where your metatarsal bones are. You have five metatarsal bones and mostly it only affects the first one or two of your toes. It can happen on just one foot, or both. The pain is normally just behind your toes or at the ball of your foot. The pain can feel like a dull ache, a burning sensation and vary from mild discomfort to so painful it affects how you walk.

What Causes It?

Anything that puts extra stress or weight forward onto the front of your foot can cause metatarsalgia. Risk factors include:

• High heeled shoes – forcing as much as 95% of your body weight forward onto your forefeet, rather than the roughly 50-50% between front and heel
• Genetic foot shape (biomechanics) – particularly high arches, called pes cavus and supination or excessive pronation
• Claw or hammer toes – forcing your metatarsals to flex down towards the ground
• Previous bunion surgery to correct bunions (hallux valgus) displacing extra weight through the ball of your foot
• Arthritis
• A stiff ankle that is plantar flexed (down towards the ground) with reduced dorsiflexion (when you pull your foot up towards you)
• Athletes involved in sports that place more force on the forefoot – dancers, runners (especially barefoot running), footballers and tennis players.
• A short 1st metatarsal bone, leading to more weight onto your 2nd metatarsal bone
• A collapsed transverse arch.

How Can It Be Treated?

Stopping the pain, or even preventing it from occurring in the first place means that we must identify the underlying cause(s) and correct them, rather than just treating any pain superficially in the short term. Here at Dubai Podiatry Centre, we carry out detailed lower limb biomechanical assessments, looking at your foot posture and function, range of motion in your joints, medical history, activity levels and lifestyle, footwear, gait (your unique walking and running style) and much more! We can then work to correct or alleviate the underlying problem.

Treatment options depend on the underlying cause – such as biomechanics, footwear, previous surgery.

Biomechanical issues such as supination, excessive pronation or ankle stiffness can generally be corrected with the use of corrective custom orthotics, which our Podiatrists make in our orthotics lab from your individual foot mold, applying their prescription depending on your diagnosis to alleviate force away from the forefoot or to correct the motion and posture of your foot and ankle.

Transverse arch collapse, neuromas and neuritis may be treated with either custom orthotics or perhaps even some specialist metatarsal padding placed at very specific points within your footwear.

Post bunion-surgery, it is important to follow the advice of your orthopaedic surgeon for follow up splinting, care and post-surgical orthotics to hold his/her good work in place. Orthopaedic surgeons commonly refer to us for post surgical orthotics.

We also provide footwear advice for both sports and smart dress / work shoes that we have pe rsonally researched. Good footwear options for both men and women are available in Dubai – one of the many great benefits our city has are the vast range of shopping malls and options! Makers such as Church’s (for both men and women) and Ferragamo are amongst our favourites and provide stylish low-heeled foot comfort and earn admiring glances from the boardroom at DIFC to an evening of fine dining. Options for casual and sports wear are wide and varied and we are delighted to advise each patient on the style, make and model of sports or casual shoe they should shop for to suit their specific foot shape and gait. If you’re advised orthotics, our bespoke custom orthotics are designed to be worn discreetly within even the most slim fit of football cleats or elegant work shoes.

Any form of burning, ache or pain at your forefoot is not ‘normal’ and you do not have to tolerate it. Foot pain can have real impact on your quality of life – making you feel miserable, upset and even avoiding activities you used to enjoy such as running around with the kids, a jog after work or strolling through the mall with friends.

What Do I Do Now?

We’re here because we understand how foot pain can affect you, and our aim is to get you back to healthy, pain free feet in the shortest time.